title: Effects of combined treatment with ambroxol and ciprofloxacin on catheter-associated Pseudomonas aeruginosa biofilms in a rat model.
abstract: BACKGROUND
  Pseudomonas aeruginosa is an opportunistic pathogen that causes potentially devastating infections in immunocompromised patients. These infections are particularly difficult to treat if a biofilm forms, which is likely if foreign bodies are present.
  
  
  OBJECTIVE
  This study aimed to investigate the effect of ambroxol combined with ciprofloxacin on P. aeruginosa biofilm in a rat model.
  
  
  METHODS
  A rat model of acute lung infection was created by endotracheal (ET) intubation with a tube covered with a P. aeruginosa biofilm. The rats were treated with ciprofloxacin alone, ambroxol alone, or a combination of both for 7 days. The microstructure of the biofilm on the tube was assessed by scanning electron microscopy (SEM). The numbers of bacterial colonies in the lungs and on the ET tube were measured on agar plates. Pathological changes in the lungs were observed with hematoxylin and eosin staining.
  
  
  RESULTS
  Changes in the microstructure of the biofilm after combined treatment were demonstrated by SEM. Ambroxol combined with ciprofloxacin significantly reduced the number of bacteria in the lungs and ET tube compared to the single treatments (p < 0.05). The pathological changes in the lungs were also mildest after the combined treatment.
  
  
  CONCLUSIONS
  The combination treatment of ambroxol with ciprofloxacin has a high ability to eradicate P. aeruginosa biofilms in vivo. These initial results provide the basis of a new strategy for the treatment of P. aeruginosa infections.
authors.affiliation: Department of Neonatology, Children's Hospital, Chongqing Medical University, Chongqing, China. qilu_qi @ hotmail.com
authors.forename: Qi
authors.initials: Q
authors.lastname: Lu
authors.forename: JiaLin
authors.initials: J
authors.lastname: Yu
authors.forename: Lei
authors.initials: L
authors.lastname: Bao
authors.forename: Tao
authors.initials: T
authors.lastname: Ran
authors.forename: Haiying
authors.initials: H
authors.lastname: Zhong
mesh_terms: D000551:Ambroxol / Q000494:pharmacology*; D000818:Animals; D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D018441:Biofilms / Q000187:drug effects; D057785:Catheters / Q000382:microbiology; D002939:Ciprofloxacin / Q000494:pharmacology*; D004195:Disease Models, Animal; D004359:Drug Therapy, Combination; D007442:Intubation, Intratracheal; D008168:Lung / Q000382:microbiology / Q000473:pathology; D008855:Microscopy, Electron, Scanning; D011552:Pseudomonas Infections / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D011550:Pseudomonas aeruginosa / Q000502:physiology*; D051381:Rats; D012141:Respiratory Tract Infections / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology
chemical_list: D000900:Anti-Bacterial Agents; D000551:Ambroxol; D002939:Ciprofloxacin